What's New in Medicare for 2027: The Changes That Matter This Open Enrollment

Part D: a higher cap and deductible

The yearly cap on what you pay for covered drugs, which started in 2025 under the Inflation Reduction Act, is still in place, but the amount moves each year with drug spending. According to KFF's open-enrollment guide, the cap is $2,400 for 2027, up from $2,100 in 2026. Once your out-of-pocket spending on covered drugs reaches the cap, you pay nothing more for covered drugs for the rest of the year.

Two things don't count toward that cap: your monthly premium, and drugs your plan doesn't cover. That's why the plan's drug list (formulary) still matters as much as ever.

The standard deductible can be as high as $700 in 2027, up from $615. Many plans charge less, and some charge no deductible at all, so compare the deductible plan by plan rather than assuming the maximum.

Stand-alone drug plan premiums: the cushion ends

For 2025 and 2026, Medicare ran a voluntary Part D Premium Stabilization Demonstration that helped keep stand-alone drug plan premiums from jumping after the redesign. CMS announced on July 28, 2026 that the demonstration ends after 2026, so 2027 premiums are set without it.

CMS projects the average stand-alone drug plan premium will rise only slightly, from about $35.09 to $36 a month, and it set the 2027 base beneficiary premium (the figure used to calculate late-enrollment penalties) at $41.33, up from $38.99. Averages hide a lot, though. Your plan's 2027 premium could rise, fall, or stay flat, and the only way to know is to check it.

If you're in a Medicare Advantage plan with drug coverage, CMS projects the average Part D portion of those premiums will fall in 2027. Again, that's an average; look at your own plan's notice.

Negotiated prices for 15 more drugs

Starting January 1, 2027, Medicare's negotiated prices take effect for a second group of 15 drugs, following the first 10 that started in 2026. The list includes:

• Ozempic, Wegovy and Rybelsus (one shared price)
• Trelegy Ellipta and Breo Ellipta
• Xtandi, Pomalyst, Ibrance and Calquence
• Ofev, Linzess, Xifaxan and Otezla
• Austedo / Austedo XR, Tradjenta, Janumet / Janumet XR and Vraylar

A negotiated price is what Medicare's plans pay for the drug, not what you pay at the pharmacy. Your copay or coinsurance still depends on how your 2027 plan covers the drug: its tier, your deductible, and whether you've reached the cap. If you take one of these drugs, enter it in Medicare's Plan Finder to see what each 2027 plan would actually charge you.

New star ratings for 2027

CMS rates Medicare Advantage and Part D plans from 1 to 5 stars on quality and service. The 2027 ratings, released October 8, 2026, show about 71% of Medicare Advantage enrollees in plans rated 4 stars or higher. The average overall rating dipped slightly, from 4.01 to 3.99, and 15 Medicare Advantage contracts earned 5 stars nationwide.

Stars are a useful tiebreaker, not a substitute for checking your own doctors and drugs. One rule worth knowing: if a 5-star plan is offered where you live, you can switch into it once at almost any time of year, not only during open enrollment. Plan Finder marks those plans with a high-performing icon.

Some plans are ending for 2027

Every year some insurers end plans or stop offering them in certain counties, and 2027 has more of this than usual, including large exits by national insurers. If your Medicare Advantage or drug plan won't be offered next year, your plan was required to send you a non-renewal notice by early October.

If you got one, don't ignore it. You can choose a new plan during open enrollment, and you also get extra time after December 7 to pick one. In some situations you also get a one-time right to buy a Medicare Supplement (Medigap) policy without health questions. We'll cover those rights in detail in our next post. If you do nothing, you'll generally end up in Original Medicare without drug coverage, which can leave a costly gap.

Things that aren't new but still matter

• Insulin: covered insulin in Part D still costs no more than $35 for a month's supply.
• Medicare Prescription Payment Plan: you can still ask your drug plan to spread your out-of-pocket drug costs into monthly payments instead of paying large amounts at the pharmacy.
• The 2027 Part B premium and deductible usually come out in mid-November. We'll post them as soon as CMS publishes them; until then, don't trust any number you see quoted.
• Medicare Advantage Open Enrollment (January 1 to March 31, 2027) still lets people already in a Medicare Advantage plan make one change after the new year.

What to do before December 7

You don't have to change plans. But don't let your plan roll over unread, because 2027 has real changes. A simple order of operations:

• Read the Annual Notice of Change your plan mailed in late September. It lists your plan's 2027 premium, deductible, drug coverage and network changes.
• Write down every prescription, with dose, and the pharmacies you use.
• Enter them in Medicare's Plan Finder and compare each plan's estimated total yearly cost, not just the premium.
• Call your doctors' offices and ask which 2027 plans they'll accept.
• Check the plan's star rating, and whether a non-renewal notice means you need to choose something new.
• Make your decision by December 7. What you hold on December 8 is your plan for 2027, with only narrow exceptions.

Free help with the comparison

In Wyoming and Utah, Jordan Jenkins (licensed agent, NPN 21725314) can walk through the plans he offers against your doctors and prescriptions at no cost to you; schedule a time here. In Nevada, our Nevada-licensed agents Eric Jenkins and Angie Oceguera can help (Nevada Medicare help). Your State Health Insurance Assistance Program (SHIP) also offers free, unbiased counseling, and 1-800-MEDICARE (1-800-633-4227) is open 24/7.

For the full list of what you can and can't change during the window, see Medicare Open Enrollment 2027: Dates, Deadlines and What to Actually Do and our Open Enrollment 2027 calendar.

Educational information only, not a recommendation of any plan. We do not offer every plan available in your area; for all of your options, visit Medicare.gov or call 1-800-MEDICARE. Sources: CMS 2027 Star Ratings fact sheet (Oct. 8, 2026); CMS Part D 2027 bid and premium announcement (July 28, 2026); CMS fact sheet on negotiated prices for 2027; KFF, Medicare Open Enrollment and Coverage Options: Key Questions and Answers.